Individual
JANE FONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
263 7TH AVE, BROOKLYN, NY 11215-3689
(718) 246-8510
Mailing address
263 7TH AVE, BROOKLYN, NY 11215-3689
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
176719
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01255861
—
NY
Enumeration date
10/10/2006
Last updated
07/08/2007
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